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What Factors Predict Conversion to THA After Arthroscopy?

John M Redmond1,2, Asheesh Gupta1, Kevin Dunne1

  • 1American Hip Institute, Westmont, IL, USA.

Clinical Orthopaedics and Related Research
|July 9, 2017
PubMed
Summary
This summary is machine-generated.

Hip arthroscopy may require conversion to total hip arthroplasty (THA) in some cases. This study identified risk factors and developed a calculator to predict THA likelihood after hip preservation surgery.

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Area of Science:

  • Orthopedic Surgery
  • Biostatistics
  • Medical Informatics

Background:

  • Hip preservation surgery aims to alleviate symptoms and avoid total hip arthroplasty (THA).
  • Failure to relieve symptoms can lead to reoperation, increasing patient risk, recovery time, and costs.
  • A predictive tool for THA risk after hip arthroscopy is currently unavailable.

Purpose of the Study:

  • Identify preoperative and intraoperative variables associated with THA conversion after hip arthroscopy.
  • Develop a predictive tool to estimate the likelihood of THA following hip arthroscopy.

Main Methods:

  • A longitudinal database of patients undergoing hip arthroscopy from 2009-2011 was analyzed.
  • Patients who underwent conversion to THA were compared to a control group who did not.
  • Multivariate regression analysis of 41 variables was performed to identify risk factors.

Main Results:

  • Older age, lower modified Harris hip score, decreased femoral anteversion, and revision surgery were associated with higher THA risk.
  • Femoral Outerbridge Grades II-IV and acetabuloplasty also increased the likelihood of conversion.
  • Lack of femoral osteoplasty showed a trend towards lower THA risk.

Conclusions:

  • Several risk factors predict THA conversion after hip arthroscopy for labral tears.
  • A weighted calculator was developed to aid in patient counseling regarding THA risk.
  • Further research is needed to identify optimal candidates for hip preservation and improve outcomes.